Medicaid Provider Spending

$1.09 trillion in Medicaid claims data, 2018–2024 · 617K+ providers
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MIDDLEBURY DENTAL GROUP

NPI: 1851404271 · MIDDLEBURY, VT 05753 · Endodontist · NPI assigned 08/17/2006

$3K
Total Medicaid Paid
136
Total Claims
109
Beneficiaries
3
Codes Billed
2018-10
First Month
2023-04
Last Month

Provider Details

Authorized OfficialMONTGOMERY, KIM (OWNER/DENTIST)
NPI Enumeration Date08/17/2006

Related Entities

Other providers sharing the same authorized official: MONTGOMERY, KIM

ProviderCityStateTotal Paid
BOTETOURT COUNSELING CENTER INC BLUE RIDGE VA $404K

Monthly Spending Trend

Yearly Breakdown

YearClaimsTotal Paid
2018 58 $1K
2019 33 $566.00
2020 14 $350.00
2021 15 $350.00
2023 16 $270.00

Billing Codes

CodeDescriptionClaimsBeneficiariesTotal Paid
D0120 Periodic oral evaluation - established patient 67 57 $1K
D1206 Topical application of fluoride varnish 51 39 $738.00
D1110 Prophylaxis - adult 18 13 $564.00